Pineapple-flavoured oral vaccine Uromune gives hope to people suffering urinary tract infections

Symptoms include a burning feeling when passing urine, needing to urinate frequently and a tender abdomen.

When Wellington woman Alex gets a urinary tract infection (UTI), the pain can be so sore she has to sit down all day. She constantly feels like she needs to go to the bathroom, and when she does, it burns.

When Alex doesn’t have a UTI, she anxiously does everything in her power to prevent another.

A new pineapple-flavoured oral vaccine is now offering an alternative to endless courses of antibiotics for people suffering recurring UTIs.

UTIs are caused when bacteria enter the urinary system. They are significantly more common in women - more than half will experience one in their lifetime.

Alex, 30, was at primary school when she got her first UTI and continued to get them when she was run-down or sick.

Becoming sexually active later in life was like a “catalyst for getting them all the time”, she told the Herald.

Sex could not be a spontaneous act, unless Alex wanted to increase the risk of getting a UTI, and instead involved a lot of admin.

Alex would drink a “ludicrous” amount of water beforehand so she would need to go to the bathroom several times in one night to flush out bacteria. She would have a shower to make sure she was as clean as possible, and take supplement pills or antibiotics proactively in the days following.

“It’s the anxiety around it and it creates this question of: ‘Is this worth it?’. That’s the most upsetting thing, because sex is meant to be fun.”

She has taken sick days from work and university to recover from UTIs.

“I’ve had times where I have just had to sit down all day because the pain is so sore, or times where it’s lingering in the background and [I’m] just constantly feeling like I need to go to the bathroom... and when you do, it hurts, it burns, it’s awful.”

Alex had a bad reaction to taking antibiotics regularly and was told after an internal ultrasound she was just unlucky in that her anatomy made her more prone to UTIs.

The infections have been significantly reduced after she discovered a supplement called d-Mannose, a type of sugar. It’s advertised as deterring bacteria from adhering to the bladder and urinary tract wall.

Alex had not heard about a new oral vaccine called MV140, known as Uromune. It’s made of inactivated whole bacteria of the four most common bugs that cause UTIs in men and women.

It’s pineapple-flavoured and is sprayed under the tongue daily for about three months.

Doctors report seeing promising results

Dr Eva Fong leads the Female and Functional Special Advisery Group for the Urological Society of Australia and New Zealand.

People with recurrent UTIs, meaning they happen several times a year, can be put on long-term antibiotics to prevent infection, Fong said.

A high rate of use or overuse of antibiotics in a community can lead to higher rates of antibiotic resistance, making infections more difficult to treat, she said.

“Antibiotics need to be used for the shortest period of time possible, need to be the right antibiotic and only prescribed when appropriate for the disease. If we can prevent infections, that would be even better, as this will also reduce the chance of antibiotic resistance developing.”

A new vaccine called MV140, or Uromune, is offering an alternative to endless courses of antibiotics.

Fong said UTIs can lead to life-threatening infections requiring hospitalisation. However, most people can be treated in the community.

“Research studies have shown the impact extends beyond the physical symptoms, with very significant impacts on social and sexual function and relationships, work and self-esteem. This suffering is often hidden and silent.”

Fong has been prescribing the Uromune vaccine for five years now and has seen promising results.

“Many of our patients would like to avoid being on long-term prevention antibiotics, and we wish to support them in this.

“We have found it to be a very helpful option to have for our patients with recurrent UTIs.

“The research publications on Uromune generally show very positive effects. However, we do need more stringent studies to understand the effects better.”

A recent study by Canadian urologist Dr Curtis Nickel and his colleagues found 40.6 per cent of people had not experienced a UTI nine months after using the vaccine and 75.3 per cent reported a reduction in infections.

Where is Uromune available?

Medsafe group manager Chris James said the regulator has not received an application from pharmaceutical company Inmunotek for approval of its product Uromune.

“Some authorised healthcare professionals like doctors can choose to prescribe an unapproved medicine if they think their patient will benefit from it.

“Unapproved medicines have not been evaluated for their safety and efficacy by Medsafe, so healthcare providers have a responsibility to ensure all treatment meets ethical and professional standards and that their patient is fully informed.”

Another Wellington woman who recently started using Uromune paid $275 for the vaccine after it was recommended by her GP.

Pharmac chief medical officer Dr David Hughes said Pharmac has not received an application to fund Uromune.

“Once an application is submitted to Pharmac and Medsafe, we will be able to consider it for funding.

“In February 2024, we announced we’re changing our process so we can assess a funding application at the same time Medsafe is assessing it for regulatory approval. This means that medicines will be able to be considered for funding sooner.”

What is a urinary tract infection?

UTIs are caused by bacteria getting into the urinary system through a tube urine passes through, the urethra.

Women are more likely to get these infections because their urethra is shorter, so the germs have less distance to travel to the bladder.

Antibiotics are available from some pharmacies without a prescription from a doctor being required. However, people with recurrent UTIs can become resistant to these.

Other antibiotics are available by prescription from a healthcare provider, and some people are even given a low dose to take every day for a few months.

Symptoms include a burning feeling when passing urine, needing to urinate frequently and a tender abdomen.

Women are often told to drink plenty of water and urinate after having sex to prevent UTIs from occurring.

Health New Zealand - Te Whatu Ora advises there is no good evidence that cranberry juice or supplements can prevent infections.

Georgina Campbell is a Wellington-based reporter who has a particular interest in women’s health, local government, transport, and seismic issues. She joined the Herald in 2019 after working as a broadcast journalist.